Better, sooner, more convenient health care in Midlands

66. Our NetworkA focus on workforce knowledge, skills and attitudePutting primacy back into primaryAt the moment many people in the health sector equate primary care with rudimentary care.A parallel is often drawn with education, where primary school is to a tertiary institution what primarycare is to tertiary care. The parallel we need to foster is that of a primary advisor vs specialist advisor.A primary advisor typically has a more rounded knowledge of a subject and takes advantage of morespecialised advice when they determine it is required.This is consistent with the Duty of Care model we are implementing in the Midlands region, whereprimary health care is associated with primacy, that it is, by necessity, at the centre of our modelof care.Primary Healthcare has, and always retains, the primary Duty of Care for their patients.In this model the General Practitioner, as the pre-eminent generalist in the health system, is theprimary diagnostician in a patient’s life. This role is truly critical and belongs at the forefront of apatient’s healthcare.It is this role that we wish to highlight, encourage and give focus.The General Practitioner is the diagnostic heart of his or her primary care team.This work obviously dovetails the work to be done on devolution within primary health teams -untying issues of control and status from issues of patient well-being and capacity management.Our vision is a model where we are able to improve quality of care outcomes by empowering andmotivating teams of people who specialise in primary health care.To achieve this we will implement the following strategies:• The implementation of the Regional Referral Centre/Patient Access Hub and the implementationof an improved discharge process will allow the General Practitioner to retain the primary Duty ofCare overview throughout a patient’s journey within the health system.• Education regarding the legal Duty of Care issues and how they relate to the delegation andtransfer of patient care to encourage a more collaborative, team based approach to apatient’s care.• Improved access to patient’s records to allow all members of a patient’s health care team tocollaborate and to bring their particular skills to bear on a patient’s care.• Improved and streamlined access to diagnostics will allow General Practitioners to maintain directinvolvement in a patient’s care.• The use of pilot Integrated Family Health Centres as case studies to illustrate to all GeneralPractitioners the benefits of taking a team approach rather than an individual approach to apatient’s primary health care.• The introduction of Medical PAs for all General Practitioners in Integrated Family Health Centresto encourage more efficient handling of administrative and non-clinical activities.• Managing patient expectations, through a managed communication programme, of the role oftheir primary health care team rather than only a General Practitioner.• Demonstrating to patients, through improved and more timely communication surroundingreferrals, diagnostics, and discharge processes the role of their primary health care team as theirprimary health team.68